Effective management of chronic urticaria

Urticaria (also known as hives, weals, wheals or nettle rash) is a superficial swelling of the skin (epidermis and mucous membranes) that results in a red, raised, and intensely itchy rash (National Institute for Health and Care Excellence (NICE), 2024). It is usually divided into acute and chronic forms, becoming chronic when daily, or almost daily, wheals continue for 6 weeks or more, although many attacks of acute urticaria settle much more quickly (Sabroe et al, 2022). An estimated 40% of patients with chronic urticaria also have associated angio-oedema (Morley, 2022). The most common underlying mechanism is the release of histamine from mast cells with consequent capillary dilatation and tissue oedema.

In the UK, approximately 15% of people experience urticaria at some time in their lives and, for around 40–50% of people with urticaria, the cause of their condition is unknown (British Association of Dermatologists (BAD), 2024)